Willamette General & Colon-Rectal Surgery Pc
LBN: Willamette General & Colon-Rectal Surgery Pc
Willamette General & Colon-Rectal Surgery Pc is an health care organization with primary practice located at 19875 Sw 65Th Ave Suite 260, Tualatin OR 97062-8353. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty.
Willamette General & Colon-Rectal Surgery Pc can be contacted via phone (503) 691-1743, or through Evetts, Brent K via phone (503) 691-1743.
Contact Information
Primary practice address
19875 Sw 65Th Ave Suite 260
Tualatin OR 97062-8353
Phone: (503) 691-1743
Fax: (503) 691-0983
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD20653 | Oregon |
Profile Details
| NPI number | 1396736518 |
|---|---|
| LBN Legal business name | Willamette General & Colon-Rectal Surgery Pc |
| DBA Doing business as | |
| Authorized official | Evetts, Brent K Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 4th, 2005 |
| Last updated | Sep 9th, 2014 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396736518 | NPPES |
| Oregon | Other | R105002 | MEDICARE PTAN |
| Oregon | MEDICAID | 150330 | MEDICARE PTAN |
| Oregon | Other | 1375470 | MEDICARE PTAN |
| Oregon | Other | 000035001 | MEDICARE PTAN |
| Oregon | Other | 3007286-01 | MEDICARE PTAN |
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